The latest news from and about EngenderHealth, a leading international nonprofit working in sexual and reproductive health. For more information, visit our web site or join us on YouTube, Facebook, and Twitter.

Tuesday, March 31, 2009

As you know, we have been urging President Obama and the U.S. Congress to commit $1 billion to international family planning programs in 2010--which would be part of the Federal International Affairs Budget. The House and Senate budget committees have now approved a 2010 budget with significantly less funding for international affairs than in President Obama's original budget proposal, which called for $53.8 billion. The House committee proposes spending 10% less on international affairs than President Obama's budget, and the Senate committee calls for a 7.4% reduction.

The International Affairs Budget supports critical global development and health initiatives that save children's lives, prevent the spread of HIV and malaria, and provide women and couples with lifesaving family planning that lets them plan their futures and offers opportunities to escape the cycle of poverty. We need to ensure Congress fully funds these vital international programs. The global financial crisis has only worsened conditions for the world's most vulnerable people, and our support now can significantly impact their lives.

Senators John Kerry (D-MA) and Richard Lugar (R-IN) have introduced an amendment in the Senate to restore President Obama's original request level for the International Affairs Budget. It is very important that you e-mail a letter to your Senators and urge them to co-sponsor and vote for the Kerry-Lugar Amendment and oppose any other reductions in funding. You can also call the Senate switchboard at (202) 224-3121 and ask to speak your Senator's office.

If I had a billion dollars, I know exactly how I would spend it: improving women's access to family planning in the world's poorest communities.

Some might think this is an unusual choice. But throughout my 29-year career as a doctor and public health professional working in developing countries, I have seen first-hand how contraception can change women's lives-allowing them and their families to survive, thrive, and plan for better futures.

We need to remember - amidst daily reports about a troubled economy here in the United States - that many of those living on the other side of the world confront daily emergencies of their own: poverty, malnutrition, HIV and AIDS, lack of health care, civil strife, and depleted environmental resources.

There's no doubt that $1 billion is a lot of money. But for what amounts to just .03% of President Obama's proposed federal budget, a $1 billion investment in family planning can help mitigate all of these challenges at once.

Family planning as a global health and development priority does not get the attention it deserves, particularly the direct connection between population and poverty. The chances that you can achieve a better life for your family are diminished when you are struggling just to feed and support your children. But with smaller families, parents can afford more for each child-providing better food, shelter, education, and health care-and can save more. This greatly improves their chances of breaking the cycle of poverty.

With better access to family planning come opportunities to improve social, political, and environmental conditions. When women and couples can decide when to have children, their opportunities outside the home can also expand, and they may contribute more to their communities socially and economically. There is less competition for food, jobs, and housing and more equitable and less harmful use of natural resources. For families in rural areas, this could reduce the need to seek a better life in urban areas, where the daily influx of new migrants strains already limited infrastructure.

Yet right now, millions of women and couples who wish to limit or space their births have no way to access the contraception that would let them do so. Over the last several years, U.S. support for family planning programs has dwindled while the need for it has increased, and few donors have stepped in to fill this gap. So a good portion of a $1 billion investment is needed just to rebuild these programs to the levels they were at several years ago. And across Africa and Asia, high levels of unmet need for contraception are likely to only grow as the largest youth generation in the world's history comes of reproductive age.

These are all compelling reasons to support family planning, but the bottom line for me is that it is a right, and not having access to it is a price paid in women's lives. Maternal mortality continues to devastate families - with more than 500,000 women dying during pregnancy or childbirth every year. Up to one-third of these deaths could be prevented if women had access to contraception. And, family planning reduces deaths from AIDS; it is the most effective way of preventing mother-to-child transmission of HIV.

the coming weeks, President Obama will be making allocations for the fiscal year 2010 federal budget. Please join me in calling on him to raise the United States commitment to international family planning programs to $1 billion in 2010-less than a penny per day per American.

In today’s plenary session, “Including Men and Masculinities in Gender Equality Policies,” one of the speakers said something that really struck me. Annikenn Huitfeldt, the Minister of Gender Equality and Children in Norway, posed the question, “How do we move from discussing “being well” to focusing on well-being?” She challenged us to think about all of the factors that comprise a person’s well-being, and that lead to a family’s well-being.

In the context of male engagement, one aspect of well-being for many men is being able to be fully involved in family life, yet laws and policies don’t always support this. To support well-being for everyone—men, women, and families—national policies are needed in many, many countries that grant men paternity leave, that allow men to be present in labor and delivery rooms, even for something as simple has making sure that there are family diaper stations in public restrooms.

Ms. Huitfeldt’s speech illustrated perfectly the need to work at all levels to bring about change, and affirmed for me that in the Men As Partners program, we’re definitely on the right track.

Monday, March 30, 2009

The opening session here at MenEngage reminded me that I was witnessing a historic moment: The focus on engaging men and boys to achieve gender equity has emerged as a top priority for both human rights and public health activists and advocates in recent years.

The Symposium, and the support it is receiving from UN agencies, is a testament to this positive change. The conversation is no longer about why it is important to involve men; instead, we are now talking about how to scale up current partnerships, advocacy efforts and effective programming. It is an inspiring time to be in this field.

In the coming week, I hope we have a chance to examine the shared responsibility among both men and women for bringing about change—it is not only men who hold traditional attitudes about gender role. Women, too, may reinforce such stereotypes. Seemingly innocent comments like "take it like a man" are really reminders that boys and men should hide their emotions or else they could be viewed as being too "feminine"—too weak. Every unchallenged stereotype becomes a step back in achieving gender equality and social justice. We can all change this as individuals, which leads to community change, which leads to.... As I said, it's an inspiring time to be in this field.

Theresa P. Castillo has worked domestically and internationally in the fields of sexual and reproductive health, adolescent mental health and health disparities for over 14 years. She received her A.B. in psychology and pre-medicine from University of Chicago. Her graduate training includes a Masters degree in Public Health Education with a focus on women’s health, violence prevention, and cultural competency among immigrant/ refugee populations from Columbia University. She is a Certified Health Education Specialist, Returned U.S. Peace Corps Volunteer and was an Emerging Leaders fellow for the U.S. Department of Health and Human Services. Currently, Theresa is a Senior Program Associate for EngenderHealth with the Men As Partners® Program. She lives in New York.

The magnitude of what I am a part of hit me square in the face listening to the introductory remarks during of the Global Symposium for Engaging Men and Boys in beautiful Rio de Janeiro. For the first time, I was in a room surrounded by people who really get what my work is about, people who are passionate, driven and committed to making gender equity a worldwide reality.

The Symposium is helping us learn from one another and reinforcing that we’re all together on this journey. But more than that, once again I realize that the smallest act can lead to positive change. It takes but one person....what have I done to make a change today?....what about you?....Ciao.

Flavian Rhode is currently working with EngenderHealth's Men As Partners® program in Namibia, assisting local organizations in incorporating male engagement activities into their programs. Mr. Rhode was formerly head of ChildLine. He also has experience in counseling, particularly couples counseling and relationships. Mr. Rhode has tertiary postgraduate qualifications in psychology and the performing arts. He is currently enrolled at the University of Stellenbosch, where he is pursuing a Masters degree in Public Health.

The mood was celebratory-the fact that more than 450 of us had gathered for the first global event for activists and practitioners supportive of male involvement was a reason to cheer! But there was also a cautionary tone: let's be realistic.we have a long way to go.

One veteran of the women's rights movement, Kim Bolduc, UN Resident Coordinator for Brazil, offered an image that stuck in my mind: Historically, when women gathered in global forums to act on issues related to gender equity and, ultimately, the well-being of women and families, there were often empty chairs. These empty chairs represented missing men, whose presence and commitment could have profoundly impacted and expedited progress on a range of sexual and reproductive health issues. I found this a mournful and regretful metaphor for opportunities lost.

Nevertheless, a spirit of hope pervaded and the speakers repeatedly lauded the efforts of individuals, organizations and governments for recognizing a basic idea - one which has informed EngenderHealth's own Men As Partners Program for more than 12 years: The beliefs and actions of men are intimately linked to the social well-being and public health of men, women and children.

Here in Rio, the chairs are full. Over the course of this week, the Symposium will examine how positive male involvement can lead to better health, indeed to a better life, for everyone. It's an issue I think about daily, and it reaffirms for me our decision to make CHAMPION about families. Our byline is "Men as facilitators of family health." We are building on men's capacity for leadership to act on behalf of their partners and families-the people who matter to them the most-while working to sensitize them, communities and policy makers that gender equality has health benefits for us all.

Eric Ramírez-Ferrero was born in New York City in 1963 of Cuban immigrant parents. He was raised in New York and in Enid, Oklahoma. He received his A.B. in biology and anthropology from Bennington College in 1985. His graduate training includes an M.P.H. in population, family and reproductive health from the Bloomberg School of Public Health of Johns Hopkins University, and an A.M. and Ph.D. in anthropology from Stanford University, where he specialized in critical medical anthropology and feminist theory. His doctoral dissertation, Troubled Fields: Men, Emotions and the Crisis in American Farming (Columbia University Press, 2005), is a feminist analysis of men’s health in light of the ongoing economic restructuring of rural communities in the United States. Ramírez-Ferrero has taught at Oklahoma State University and the University of Tulsa. He has worked domestically and internationally in the promotion of reproductive and sexual health for the Area Health Education Centers Program, Planned Parenthood, and Family Health International. He is currently chief of party for EngenderHealth in Tanzania, leading CHAMPION—a project to promote positive male involvement in the prevention of HIV and other adverse reproductive health outcomes. He lives in Dar es Salaam.

Friday, March 27, 2009

EngenderHealth and the U.S. Agency for International Development (USAID) today celebrate a milestone in global maternal health: A total of 10,000 women have received fistula repair surgery with U.S. support since 2005. Fistula, a devastating childbirth injury affecting millions of women in developing countries, can be surgically repaired up to 90% of the time, but most of those with the condition lack access to a skilled surgeon or health center, making treatment out of reach.

Four years ago, USAID launched a global effort to both treat and prevent fistula. To date, through initiatives such as the EngenderHealth-led Fistula Care Project, and in collaboration with local governments, regional health care organizations, and faith-based organizations, medical teams in 12 countries and 25 health facilities across Africa and Asia have been trained and equipped to provide surgery for fistula.

It is these trained medical professionals, as well as their supporting institutions, whose dedication has made it possible for 10,000 women to regain dignity and hope through fistula repair surgery. We honor the tireless efforts of the surgical teams as we mark this maternal health milestone.

Obstetric fistula is an injury caused by prolonged obstructed labor, when the head of the baby cannot pass safely through the woman's birth canal. The baby often dies as a result, and the woman is left with an abnormal opening in the birth canal and chronic incontinence. If left untreated, fistula can lead to skin ulcerations and infections, kidney disease, social isolation, and even death.

The hopeful part of the story is that in addition to most cases being reparable, fistula is almost entirely preventable. This is why the Fistula Care Project is working to improve access to emergency obstetric care and cesarean section for women who develop complications during delivery. Together with skilled attendance at all births and the availability of voluntary family planning, this could make fistula as rare in the developing world as it is in the industrialized world. The Fistula Care Project is working to engage all levels of society to raise awareness about fistula and its underlying causes, including early pregnancy, poverty, and a lack of education and empowerment for women and girls.

As the largest USAID-supported effort to both treat and prevent fistula, the Fistula Care Project will keep you apprised of our work to transform the lives of thousands more women and girls around the world--work that is possible thanks to your partnership. To learn more, please visit our web site at www.fistulacare.org.

Gratefully yours,

Karen J. BeattieProject Director Fistula Care Project

The Fistula Care Project is a five-year cooperative agreement funded by USAID and managed by EngenderHealth. The project works to address the enormous backlog of women awaiting life-altering fistula repair, ensuring that they receive timely and quality care from trained providers. At the same time, it works to remove barriers to emergency obstetric care that lead to fistula in the first place, so that women in labor get to the right place with the right services at the right time. The project is supporting a network of facilities offering a continuum of services, from emergency obstetric care, referrals, and family planning to complex fistula repairs and advanced surgical training. Visit www.fistulacare.org for more information or contact fistulacare@engenderhealth.org.

The American people, through USAID, have provided economic and humanitarian assistance worldwide for nearly 50 years. For more information about USAID and its programs, visit www.usaid.gov.

Tuesday, March 24, 2009

Today, EngenderHealth is launching the 3FOR1 campaign urging President Obama andCongress to commit $1 billion to international family planning programsin 2010. We're asking you to join us.

Family planning is a basic right. Yet, there are an estimated 201million women worldwide who want to use it, but can't--they do not haveaccess. Changing this reality through increased U.S. investment canbring significant short- and long-term returns: When women and couplesare able to plan their families, they have the chance to have healthierand better-educated children and more productive lives, which can leadto more stable and economically strong communities and countries.

President Obama has stated that he wants to change the way the UnitedStates is viewed around the world. One way to demonstrate this is tocommit to improving women's health and welfare through a stepped-upinvestment in family planning.

Right now, the U.S. budget for international family planning is not muchhigher than it was in 1974, when adjusted for inflation. To keep up withthe large and growing need for family planning, we call on thePresident to increase the U.S. contribution to this global effort to$1 billion. This represents less than one twentieth of 1% of theproposed 2010 federal budget--less than a penny per day for every American.

Help us ensure international family planning and reproductive health aretop priorities for the U.S. government. Watch EngenderHealth's new videoand write a letter to President Obama calling for $1 billion to bededicated to international family planning.

“This month, women's rights advocates are calling on men and women to join together to fight gender discrimination. They're meeting in New York for the 53rd session of the Committee on the Status of Women [March 2 – 13]. And in South Africa, two NGO's are reaching out to men to help end violence against women. They're also looking at ways to help reduce some of burdens borne by women, like providing almost all of the care for those with HIV/AIDS. From Washington, William Eagle reports.

“Johannesburg community activist Dumisani Rebombo says one out of six men in South Africa commit physical violence against women. Research by Witswatersrand University showed almost one third of sexually experienced women report their first encounter was not consensual.

“Rebombo is an organizer with the Men as Partners outreach group, part of the NGO EngenderHealth.”

Dumisani has previously appeared on Voice of America's "Healthy Living" television show. You can also hear his story, in his own words, on his digital story on YouTube, along with dozens of other men in our Men As Partners programs around the world.

About the VideoIn India, as in many parts of the world, a woman's increased vulnerability to HIV infection is largely a result of unequal gender roles. Male dominance in relationships, combined with peer pressure and traditional views of masculinity, often interferes with safe sexual practices. Furthermore, in India, rape occurs twice every minute, and nearly half of married men admit to physically abusing their wives. These problems transcend geography, economic status, and culture. Although many programs tackle these issues, they often focus on women and ignore the role of men.

EngenderHealth India saw this as an important opportunity. By partnering with local organizations, and adapting the global Men As Partners® (MAP) program, EngenderHealth developed community-based, peer-driven interventions with young men and boys. The results were dramatic: men thoughtfully engaged in discussions, role-playing, and games about gender issues. The MAP workshops created real change in participant’s attitudes toward women. Furthermore, as a gender-related HIV awareness and support program, it is the first of its kind in Asia.

Men Today, Men TomorrowIndian entertainment star Jaaved Jaffri hosts this short film, which uses interviews with HIV-positive men and their families to illustrate how EngenderHealth’s Men As Partners® in Positive Prevention program supports men in preventing HIV transmission.

Sunday, March 8, 2009

Ending violence against women and girls is one of this year’s themes for International Women’s Day—celebrated March 8. This goal is central to EngenderHealth’s own mission, every day and everywhere. View a photo essay of men involved with EngenderHealth’s CHAMPION Project in Tanzania who promote gender equity and better health in their communities.

Friday, March 6, 2009

A recent national conference organized by EngenderHealth demonstrates that reproductive health has become a top priority for the Azerbaijani government. On February 17–18, more than 100 policymakers, health care professionals, and other leaders attended the reproductive health quality improvement conference in Baku. Over the last four years, EngenderHealth has been partnering with the Azerbaijani government (through the ACQUIRE Project) to strengthen its reproductive health systems. The need for better health services is great: Like many former Soviet republics, abortion had been the main method of family planning in Azerbaijan, and contraceptive choice was severely limited.

“This conference brings reproductive health and family planning issues to a new level among parliamentarians—89% of whom are men and think that reproductive health problems are women’s concerns.”–Malahat Hasanova, member of Parliament

Participants in the meeting included four members of the Azerbaijani Parliament, officials from the government’s Ministry of Health (at the national and regional levels), doctors, health care staff, medical school administrators, and representatives of partner organizations. The discussion centered on barriers to care, and the attendees developed an action plan to address these issues.

A centerpiece of the meeting was the government officials’ presentation of a draft of the country’s first reproductive health law, which ensures the right of all Azerbaijanis to high-quality reproductive health care and family planning.

Throughout the process of developing the law and leading up to this meeting, EngenderHealth has emphasized the importance of improving the quality of reproductive health care and family planning, upholding clients’ rights to safe and effective services, and ensuring informed choice and confidentiality. EngenderHealth staff also successfully advocated for the inclusion of contraceptives on the Essential Drug List and helped the government draft the section detailing the country’s contraceptive supply needs. Additionally, EngenderHealth shared its publications on Islam and family planning, its experience working in other Muslim countries, and its expertise in applying evidence-based quality improvement approaches like COPE®.

What can communities do to help men become part of the solution for healthier families? These and other questions were debated at the launch of the EngenderHealth-led CHAMPION Project in Tanzania on February 17. More than 170 guests gathered at the Mövenpick Hotel in Dar es Salaam for the interactive event. The five-year CHAMPION Project, supported by the U.S. Agency for International Development (USAID), inspires men to become partners and leaders in combating some of the most serious reproductive health challenges in Tanzania, including HIV and AIDS.

“Men have long been acknowledged as providers, central players in the community, and on the world stage. But far less attention has been paid to men’s roles in promoting the health of the family.”–Robert Cunnane, Director of the USAID Mission in Tanzania

Each invitation for the launch had the message “Be part of the solution” and a puzzle piece, which attendees were asked to bring to the event. At the launch, the puzzle was completed and revealed a photo of a male champion, a man who had taken an active, positive role in promoting health in his family and community. The completed puzzle illustrates that it takes a community to create champions. Other such champions were featured in a photo exhibition spread throughout the venue.

Officiating at the event, the Honorable Samwel Sitta, Speaker of Tanzania’s National Assembly, noted that harmful gender stereotypes had greatly affected the country’s health systems and the health of individual citizens, accelerating the HIV epidemic.

Other attendees included Robert Cunnane, USAID Mission Director in Tanzania; Fatma Hadfidh Mrisho, Executive Chairman of the Tanzania Commission on AIDS; other government officials; and representatives of the donor community and religious organizations.

Wednesday, March 4, 2009

In our 2008 Annual Report, read about remarkable individuals who, in very different ways, are each transforming the health and lives of those in their communities and planting seeds of hope for tomorrow. Through our work, we are:

Inspiring religious leaders in Azerbaijan to share family planning information with their congregations;

Healing women in Nigeria who suffer from obstetric fistula;

Training police officers in South Africa to take a stand against gender-based violence;

Giving rural girls in Guatemala the opportunity to develop new skills and access health services;

Tuesday, March 3, 2009

The Fistula Care Project is pleased to announce the launch of its new web site: www.fistulacare.org. Supported by the U.S. Agency for International Development (USAID), Fistula Care is a global leader in building the capacity of developing countries to address fistula, a devastating vaginal injury that affects an estimated 2 million women and girls.

The Fistula Care web site is a comprehensive resource for anyone interested in or working on issues related to fistula and maternal health. Sharing program insights and technical expertise, the web site offers a host of resources and tools, including:

Training guides and curricula

Communications and social mobilization materials

Journal articles and presentations

Technical updates and program reports

Country-specific updates on current activities

The web site also features stories of women whose lives have been transformed by fistula repair. Every day, Fistula Care helps prevent and treat fistula across 11 countries in Africa and Asia. More than 9,600 women received surgical repair between 2005 and 2008 through the support of USAID, the project, and its partners.

Additionally, detailed information about the project’s on-the-ground, country-specific activities is readily available and will be regularly updated.

The Fistula Care Project is a five-year cooperative agreement funded by USAID and managed by EngenderHealth. The project works to address the enormous backlog of women awaiting life-altering fistula repair, ensuring they receive timely and quality care from trained providers. At the same time, we work to remove barriers to emergency obstetric care that lead to fistula in the first place, so that women in labor get to the right place with the right services at the right time. The project is supporting a network of facilities offering a continuum of services, from emergency obstetric care, referrals, and family planning, to complex fistula repairs and advanced surgical training. Visit www.fistulacare.org for more information or contact us at fistulacare@engenderhealth.org.

"While increasing access to fistula repair surgery restores hope and improves lives, there is no way to stem the rising backlog of fistula cases unless we prevent the injury from occurring in the first place.

"We know what works: increasing access to quality emergency obstetric services and meaningful prenatal care, ensuring the availability of contraception, delaying early marriage and childbirth, and improving education and nutrition to help girls grow and thrive. These actions, combined with stepped-up political will and community engagement, would improve countless lives."